Effects of fifth day (D5) or sixth day (D6) frozen–thawed blastocysts on neonatal outcomes

Zhen, Jingran; Sun, Zhengyi; Yu, Qi; Deng, Chengyan; Zhou, Yabo; Wang, Hanbi; He, Fang-Fang

doi:10.1017/s0967199415000696

Cited by 28 publications

(21 citation statements)

References 31 publications

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“…Ferreux et al also reported similar EMRs between D5 and D6 cryopreserved blastocyst transfers [15]. However, similar to our study, Wang et al reported a higher EMR in the D6 blastocysts than in the D5 blastocysts(16.4% vs. 11.9%), although not statistically significant [19].…”

Section: Discussionsupporting

confidence: 85%

“…Some reports showed equivalent outcomes between blastocysts formed and cryopreserved on day 5 (D5 blastocysts) and blastocysts formed and cryopreserved on day 6 (D6 blastocysts) [11][12][13][14]. Meanwhile, there is a growing body of evidence indicating that the CPR, IR, and live birth rate (LBR) with D5 blastocysts are higher than with D6 blastocysts in FET cycles [15][16][17][18][19][20]. Therefore, whether the day of blastocyst formation affects clinical outcomes remains controversial.…”

Section: Introductionmentioning

confidence: 99%

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D6 blastocyst transfer on day 6 in frozen-thawed cycles should be avoided: a retrospective cohort study

Qiu

Chen

et al. 2020

BMC Pregnancy Childbirth

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Background There is no definitive evidence about the suitable timing to transfer blastocysts formed and cryopreserved on day 6 (D6 blastocysts) in frozen-thawed embryo transfer (FET) cycles. This study aimed to investigate the suitable timing to transfer D6 blastocysts in FET cycles and to identify factors affecting clinical pregnancy rate (CPR) and early miscarriage rate (EMR) in FET cycles with blastocysts. Methods This retrospective cohort study included 1788 FET cycles with blastocysts. There were 518 cycles with D6 blastocysts, and 1270 cycles with blastocysts formed and cryopreserved on day 5 (D5 blastocysts) (D5 group). According to the blastocyst transfer timing, the cycles with D6 blastocysts were divided into cycles with D6 blastocysts transferred on day 5 (D6-on-D5 group, 103 cycles) and cycles with D6 blastocysts transferred on day 6 (D6-on-D6 group, 415 cycles). The chi-square test, independent t-test or Mann-Whitney test, and logistic regression analysis were used for data analysis. Results The CPR and implantation rate (IR) were significantly higher in the D6-on-D5 group than in the D6-on-D6 group (55.3% vs. 37.3%, 44.8% vs. 32.6%, P < 0.01). The CPR and IR were significantly higher in the D5 group than in the D6-on-D5 group (66.0% vs. 55.3%, 62.1% vs. 44.8%, P < 0.05), and the EMR was significantly lower in the D5 group than in the D6-on-D5 group (11.2% vs. 21.1%, P < 0.05). Logistic regression analysis demonstrated that transfer D6 blastocysts on day 5, instead of day 6, could significantly increase the CPR (odds ratio[OR]: 2.031, 95% confidence interval (CI): 1.296–3.182, P = 0.002). FET cycles with D6 blastocysts transferred on day 5 had a higher EMR than those with D5 blastocysts (OR: 2.165, 95% CI: 1.040–4.506, P = 0.039). Hormone replacement therapy (HRT) cycles exhibited a higher EMR than natural cycles (OR: 1.953, 95% CI: 1.254–3.043, P = 0.003), while no difference was observed in the CPR (P > 0.05). Conclusions These results indicate that the suitable timing to transfer D6 blastocysts in FET cycles may be day 5, and D6 blastocyst transfer on day 6 in FET cycles should be avoided. D6 blastocysts transfer and HRT cycles may be associated with a higher EMR.

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Section: Discussionsupporting

confidence: 85%

Section: Introductionmentioning

confidence: 99%

D6 blastocyst transfer on day 6 in frozen-thawed cycles should be avoided: a retrospective cohort study

Qiu

Chen

et al. 2020

BMC Pregnancy Childbirth

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“…The final inclusion was 13 studies that met the selection criteria for our meta‐analysis. Hence, 23 studies were included in the following meta‐analyses . The main characteristics and assessment for risk of bias of the included studies are presented in Table .…”

Section: Resultsmentioning

confidence: 99%

“…Hence, 23 studies were included in the following meta-analyses. 4,6,7,[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] The main characteristics and assessment for risk of bias of the included studies are presented in Table 1.…”

Section: Results Of the Searchesmentioning

confidence: 99%

“…Only three studies transfer euploid blastocysts. 13,16,22 Five studies only transfer one embryo per cycle, [12][13][14]16,23 while remaining studies transfer no more than two blastocysts 11,[18][19][20]22,24,27,28 or more than two blastocysts per cycle. 29,30 The decision of when blastocyst was transferred in all included studies was dependent on the day of expansion.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

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Pregnancy outcomes after day 5 versus day 6 blastocyst‐stage embryo transfer: A systematic review and meta‐analysis

Wang²,

Sun

et al. 2020

J of Obstet and Gynaecol

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Aim To compare the pregnancy outcomes after day 5 blastocyst‐stage embryo transfers (BET) versus day 6 BET following vitrified‐warmed cycle and to evaluate whether the number of embryos transferred and the chromosomal status of embryo influence effect estimates. Methods A literature search (PubMed, Embase and MEDLINE) up to January 2019 was conducted to identify studies where women with day 6 BET were compared to women with day 5 BET. Only studies published in English language, on peer‐reviewed journal were considered eligible. The following subgroup analyses were performed: (i) number of embryos transferred and (ii) chromosomal status of embryo. Results From a total of 1956 articles identified, 23 observational studies were included in the meta‐analysis. We observed that day 6 BET were associated with lower implantation rate (risk ratio, RR: 1.17, 95% confidence interval, CI: 1.10–1.24), clinical pregnancy rate (RR: 1.17, 95% CI: 1.10–1.24), ongoing pregnancy rate (RR: 1.15, 95% CI: 1.07–1.24) and live birth rate (RR: 1.22, 95% CI: 1.11–1.33) than day 5 BET following vitrified‐warmed cycle. The subgroup analysis found that the superiority of day 5 BET compared with day 6 BET is influenced by the number of embryos transferred and chromosomal status of embryos. Conclusion Current evidence shows that day 5 BET is superior to day 6 BET following vitrified‐warmed cycle in clinical practice. Due to the overall low quality of available evidence, more larger and well‐conducted studies are needed to compare the pregnancy outcomes between day 5 and day 6 BET before drawing a clear conclusion.

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Beyond appearance: Can morphologically low‐grade euploid blastocysts yield successful pregnancies?

Suzuki,

Ishida,

Yoshioka

et al. 2024

Reprod Medicine & Biology

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PurposeThe primary objective of this investigation is to evaluate how morphological quality affects the pregnancy outcomes in euploid embryos determined by preimplantation genetic testing for aneuploidies (PGT‐A). Concurrently, as a secondary objective, we aim to identify which specific aspects of morphological evaluation exert the most significant impact on these outcomes.MethodsA retrospective analysis of 451 single euploid embryo transfer cycles at our clinic was conducted. Embryos were evaluated based on the degree of blastocyst expansion, inner cell mass (ICM), trophectoderm (TE) morphology, and the day of blastocyst vitrification. Outcomes between morphologically low‐grade and high‐grade embryos were compared. Additionally, the study analyzed which morphological factors most influenced pregnancy outcomes.ResultsPregnancy outcomes were significantly lower in morphologically low‐grade blastocysts compared to high‐grade ones. Among the morphological evaluations, the ICM assessment was significantly associated with the live birth rate.ConclusionOur study indicates that the morphological quality of euploid embryos, particularly the evaluation of the ICM, plays a crucial role in IVF‐ET success.

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Effects of fifth day (D5) or sixth day (D6) frozen–thawed blastocysts on neonatal outcomes

Cited by 28 publications

References 31 publications

D6 blastocyst transfer on day 6 in frozen-thawed cycles should be avoided: a retrospective cohort study

D6 blastocyst transfer on day 6 in frozen-thawed cycles should be avoided: a retrospective cohort study

Pregnancy outcomes after day 5 versus day 6 blastocyst‐stage embryo transfer: A systematic review and meta‐analysis

Beyond appearance: Can morphologically low‐grade euploid blastocysts yield successful pregnancies?

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